Tadao Kuwano

Evaluation of Effective Energy for QA and QC: Measurement of Half-value Layer Using Radiochromic Film Density

The effective energy of diagnostic X-rays is important for quality assurance (QA) and quality control (QC). However, the half-value layer (HVL), which is necessary to evaluate the effective energy, is not ubiquitously monitored because ionization-chamber dosimetry is time-consuming and complicated. To verify the applicability of GAFCHROMIC XR type R (GAF-R) film for HVL measurement as an alternative to monitoring with an ionization chamber, a single-strip method for measuring the HVL has been evaluated. Calibration curves of absorbed dose versus film density were generated using this single-strip method with GAF-R film, and the coefficient of determination (r2) of the straight-line approximation was evaluated. The HVLs (effective energies) estimated using the GAF-R film and an ionization chamber were compared. The coefficient of determination (r2) of the straight-line approximation obtained with the GAF-R film was more than 0.99. The effective energies (HVLs) evaluated using the GAF-R film and the ionization chamber were 43.25 keV (5.10 mm) and 39.86 keV (4.45 mm), respectively. The difference in the effective energies determined by the two methods was thus 8.5%. These results suggest that GAF-R might be used to evaluate the effective energy from the film-density growth without the need for ionization-chamber measurements.

Diagnostic validity of high-density barium sulfate in gastric cancer screening: follow-up of screenees by record linkage with the Osaka Cancer Registry.

Background The use of high-density barium sulfate was recommended by the Japan Society of Gastroenterological Cancer Screening (JSGCS) in 2004. We evaluated the diagnostic validity of gastric cancer screening that used high-density barium sulfate. Methods The study subjects were 171 833 residents of Osaka, Japan who underwent gastric cancer screening tests at the Osaka Cancer Prevention and Detection Center during the period from 1 January 2000 through 31 December 2001. Screening was conducted using either high-density barium sulfate (n = 48 336) or moderate-density barium sulfate (n = 123 497). The subjects were followed up and their medical records were linked to those of the Osaka Cancer Registry through 31 December 2002. The results of follow-up during 1 year were defined as the gold standard, and test performance values were calculated. Results The sensitivity and specificity of the screening test using moderate-density barium sulfate were 92.3% and 91.0%, respectively, while the sensitivity and specificity of the high-density barium test were 91.8% and 91.4%, respectively. The results of area under receiver-operating-characteristic (ROC) curve analysis revealed no significant difference between the 2 screening tests. Conclusions Screening tests using high- and moderate-density barium sulfate had similar validity, as determined by sensitivity, specificity, and ROC curve analysis.

Half-value Layer Measurement: Simple Process Method Using Radiochromic Film

Although the half-value layer (HVL) is one of the important parameters for QA and QC, constant monitoring has not been performed because the measurements using an ionization chamber (IC) are time-consuming and complicated. To solve these problems, the use of radiochromic film (GAFCHROMIC XR TYPE R: GAF-R) with step-shaped aluminum (Al) filters, referred to herein as the simple process method, has been developed. The measurement X-ray tube voltages were 120 kV, 100 kV, and 80 kV. The Al filter area, the full exposure area, and the unexposed area were set on the GAF-R so as to obtain correct data. The HVL was evaluated using the density attenuation ratio. The HVLs obtained using the GAFR and an IC dosimeter were compared. HVLs with X-ray tube voltages of 120 kV, 100 kV, and 80 kV using the GAF-R were 4.10 mm, 3.55 mm and 2.97 mm, respectively. The difference ratios of the HVLs using the GAF-R and the IC were 1.2%, 7.6%, and 10.0%, respectively. The HVL at 120 kV can be routinely and quickly measured using the simple process method. Therefore, an IC dosimeter is not needed for HVL measurements for QA and QC. However, the HVL measurements of low energy (100 kV and 80 kV) need attention.

Reducing Non-uniformity Error of Radiochromic Film in the Diagnostic Range by Ultraviolet Exposure: Preliminary Study

Thickness irregularity of active layer is made to express density irregularity. True data by the X-rays are extracted by exposing Ultraviolet (UV) rays that prohibited exposure are exposed for radiochromic film (RF). When UV is exposed, the density irregularity is corrected. In addition, RF is initialized, thereby improving of data acquisition.

Comparing three UV wavelengths for pre‐exposing Gafchromic EBT2 and EBT3 films

Gafchromic films are used for X‐ray dose measurements during diagnostic examinations and have begun to be used for three‐dimensional X‐ray dose measurements using the high‐resolution characteristics of Gafchromic films for computed tomography. However, the problem of unevenness in Gafchromic film active layers needs to be resolved. Double exposures using X‐rays are performed during therapeutic radiology, although this is difficult for a diagnostic examination because of a heel effect. Thus, it has been suggested that ultraviolet (UV) radiation be used as a substitute for X‐rays. However, the appropriate UV wavelength has not been determined. Thus, we conducted this study to decide an appropriate UV wavelength. UV peak wavelengths of 245 nm (UV‐A), 310 nm (UV‐B), and 365 nm (UV‐C) were used to irradiate EBT2 and EBT3 films. Each UV wavelength was irradiated for 5, 15, 30, and 60 min, and irradiation was then repeated every 60 min up to 360 min. Gafchromic films were scanned after every irradiation using a flatbed scanner. Images were split into RGB images, and red images were analyzed using ImageJ, version 1.44, image analysis software. A region of interest (ROI) one‐half inch in diameter was placed in the center of subtracted Gafchromic film images, and UV irradiation times were plotted against mean pixel values. There were reactions in the front and back of Gafchromic EBT3 and the back of Gafchromic EBT2 with UV‐A and UV‐B. However, UV‐C resulted in some reactions in both sides of Gafchromic EBT2 and EBT3. The UV‐A and UV‐B wavelengths should be used. PACS number(s): 87.53 BnGafchromic films are used for X-ray dose measurements during diagnostic examinations and have begun to be used for three-dimensional X-ray dose measurements using the high-resolution characteristics of Gafchromic films for computed tomography. However, the problem of unevenness in Gafchromic film active layers needs to be resolved. Double exposures using X-rays are performed during therapeutic radiology, although this is difficult for a diagnostic examination because of a heel effect. Thus, it has been suggested that ultraviolet (UV) radiation be used as a substitute for X-rays. However, the appropriate UV wavelength has not been determined. Thus, we conducted this study to decide an appropriate UV wavelength. UV peak wavelengths of 245 nm (UV-A), 310 nm (UV-B), and 365 nm (UV-C) were used to irradiate EBT2 and EBT3 films. Each UV wavelength was irradiated for 5, 15, 30, and 60 min, and irradiation was then repeated every 60 min up to 360 min. Gafchromic films were scanned after every irradiation using a flatbed scanner. Images were split into RGB images, and red images were analyzed using ImageJ, version 1.44, image analysis software. A region of interest (ROI) one-half inch in diameter was placed in the center of subtracted Gafchromic film images, and UV irradiation times were plotted against mean pixel values. There were reactions in the front and back of Gafchromic EBT3 and the back of Gafchromic EBT2 with UV-A and UV-B. However, UV-C resulted in some reactions in both sides of Gafchromic EBT2 and EBT3. The UV-A and UV-B wavelengths should be used. PACS number(s): 87.53 Bn.

Correction of nonuniformity error of Gafchromic EBT2 and EBT3

This study investigates an X‐ray dose measurement method for computed tomography using Gafchromic films. Nonuniformity of the active layer is a major problem in Gafchromic films. In radiotherapy, nonuniformity error is reduced by applying the double‐exposure technique, but this is impractical in diagnostic radiology because of the heel effect. Therefore, we propose replacing the X‐rays in the double‐exposure technique with ultraviolet (UV)‐A irradiation of Gafchromic EBT2 and EBT3. To improve the reproducibility of the scan position, Gafchromic EBT2 and EBT3 films were attached to a 3‐mm‐thick acrylic plate. The samples were then irradiated with a 10 W UV‐A fluorescent lamp placed at a distance of 72 cm for 30, 60, and 90 minutes. The profile curves were evaluated along the long and short axes of the film center, and the standard deviations of the pixel values were calculated over large areas of the films. Paired t‐test was performed. UV‐A irradiation exerted a significant effect on Gafchromic EBT2 (paired t‐test; p=0.0275) but not on EBT3 (paired t‐test; p=0.2785). Similarly, the homogeneity was improved in Gafchromic EBT2 but not in EBT3. Therefore, the double‐exposure technique under UV‐A irradiation is suitable only for EBT2 films. PACS number(s): 87.53 BnThis study investigates an X-ray dose measurement method for computed tomography using Gafchromic films. Nonuniformity of the active layer is a major problem in Gafchromic films. In radiotherapy, nonuniformity error is reduced by applying the double-exposure technique, but this is impractical in diagnostic radiology because of the heel effect. Therefore, we propose replacing the X-rays in the double-exposure technique with ultraviolet (UV)-A irradiation of Gafchromic EBT2 and EBT3. To improve the reproducibility of the scan position, Gafchromic EBT2 and EBT3 films were attached to a 3-mm-thick acrylic plate. The samples were then irradiated with a 10 W UV-A fluorescent lamp placed at a distance of 72 cm for 30, 60, and 90 minutes. The profile curves were evaluated along the long and short axes of the film center, and the standard deviations of the pixel values were calculated over large areas of the films. Paired t-test was performed. UV-A irradiation exerted a significant effect on Gafchromic EBT2 (paired t-test; p=0.0275) but not on EBT3 (paired t-test; p=0.2785). Similarly, the homogeneity was improved in Gafchromic EBT2 but not in EBT3. Therefore, the double-exposure technique under UV-A irradiation is suitable only for EBT2 films. PACS number(s): 87.53 Bn.

Measurement of half-value layer for QA and QC: Simple method using radiochromic film density

Although it is considered that the half-value layer (HVL) of diagnostic X-rays is important for quality assurance (QA) and quality control (QC), the HVL is not constantly monitored because ionization-chamber dosimetry is time-consuming and complicated. To verify the applicability of GAFCHROMIC XR type R (GAF-R) film for HVL measurement instead of monitoring the ionization-chamber, a single-strip method for measuring the HVL has been evaluated.

Exposure Dose Reduction of Lead Acrylic Filter for Gastric Cancer Mass Screening

It is important to reduce x-ray exposure in subjects who undergo mass screening for gastric cancer. We constructed three types of lead acrylic filters and evaluated their ability to reduce exposure. X-ray tube load increase, dose area reduction, density of gastric phantom images and lead acrylic filter shadows were evaluated. Three different thicknesses of lead acrylic filters were examined, one was a regular thickness, another was half the thickness, and the other was twofold the thickness. Objectivization, reduction rate of exposure, x-ray tube load increase, and the density of each gastric phantom image was taken with or without the three types of lead acrylic filters. The filter shadow in the image of the gastric phantoms using the three types of lead acrylic filters were evaluated with 4 levels. Dose area reductions using the three types of filters were 6.03%, 10.92%, and 13.64%, for the half thickness, regular thickness, and twofold thickness, respectively (p 0.05). There was no significant difference between the density of gastric phantom images with or without the filters (p>0.05). The lead acrylic filter shadows were significantly difference among the three types filters (p<0.05). We conclude that the use of lead acrylic filters is effective for the reduction of exposure in screening for gastric cancer. A lead acrylic filter of twofold thickness is most effective for the reduction of exposure.

Effective energy measurement using radiochromic film: Application of a mobile scanner

Abstract The effective energy calculated using the half-value layer (HVL) is an important parameter for quality assurance (QA) and quality control (QC). However constant monitoring has not been performed because measurements using an ionization chamber (IC) are time-consuming and complicated. To solve these problems, a method using radiochromic film (GAFCHROMIC EBT2 dosimetry film (GAF-EBT2) with slight energy dependency errors), a mobile scanner and step-shaped aluminum (SSAl) filter is developed. The results of the method using a mobile scanner were compared with those of the recommended method using an IC in order to evaluate its applicability. The difference ratios of the effective energies by each method using a mobile scanner with GAF-EBT2 were less than 5% compared with results of an IC. It is considered that this method offers a simple means of determining HVL for QA and QC consistently and quickly without the need for an IC dosimeter.

Noise reduction of radiochromic film: median filter processing of subtraction image

Pre-ultraviolet rays exposure is a useful method to reduce non-uniformity error of radiochromic films. However, dust and scratch noises such as spike noise disturb precise measurement. To reduce these noises, median filter processing is applied for pre-subtraction and subtraction images. To reduce non-uniformity error of the thickness unevenness of Gafchromic EBT film, ultraviolet rays were exposed to correct data. There were three kinds of images obtained: first ultraviolet exposure image, second ultraviolet exposure image and the subtraction image of both. Median filer processing was performed on all these images. Eleven kinds of median filter radius factors (0.0 to 5.0) were applied using image analysis software. Data and graphs were then estimated. The maximum pixels value of dust was 229 on the second ultraviolet exposure image of film 3. After median filter preprocessing, the pixel value of the noises were similar to the minimum value. A 2.0-radius median filer is a useful factor for processing. Noise reduction that affected data of estimated images may be applied to measure radiation doses on a variety of radiochromic films. Ultraviolet exposure and subtraction method with median filter processing enable precise measurement and high spatial resolution dose distribution.